Tatara, Mark J.
Tatara, Mark J. is an individual health care provider with primary practice located at 6840 Main St Ste 200 , Downers Grove IL 60516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tatara, Mark J. can be contacted via phone (630) 869-5382.Contact Information
Primary practice address
6840 Main St Ste 200
Downers Grove IL 60516
Phone: (630) 869-5382
Fax: (630) 869-5383
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-077438 | Illinois |
Profile Details
| NPI number | 1043256324 |
|---|---|
| LBN Legal business name | Tatara, Mark J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Dec 23rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043256324 | NPPES |
| Ohio | MEDICAID | 0795794 | |
| Ohio | MEDICAID | 100355690 |
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